# DR. JOHN L.M. WADDELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1982912143
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 27721 | MS | Yes |

## Other

- **Enumeration date:** 09/21/2010
- **Last updated:** 05/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00774066 | — | MS |
| 01 | — | P01687365 | RR MEDICARE | MS |